Sen. Tim Kaine leads push to block quick repeal of health care law

The amendment, co-sponsored by Sen. Chris Murphy, D-Conn., would impose a 60-vote threshold for passage of any legislation through the budget reconciliation process that would reduce the number of people with health insurance, increase their health care premiums, or reduce benefits and the quality of care.

Kaine, the vice presidential nominee on the unsuccessful 2016 Democratic ticket, invoked President-elect Donald Trump’s promises to protect Americans’ health care.

He warned of “chaos in the economy,” health insurance markets and households across the country if Congress acts hastily in repealing the ACA without a credible replacement.

“This is not a game,” Kaine said at the end of his speech. “This is life and death.”

Virginia House of Delegates Speaker William J. Howell, R-Stafford, who led the successful GOP effort to block Medicaid expansion in the state, responded that the budget reconciliation process is a fair way to repeal key parts of the law, which Democrats adopted in 2010 without any Republican support.

“A significant part of the Affordable Care Act was passed through budget reconciliation,” Howell said in a statement. “Therefore, it is somewhat disingenuous to assert that it cannot be repealed through the same measure.”

In an interview after the speech, Kaine rated the odds of slowing the process down in the Senate at “50-50.”

“It’s good enough odds for me to fight like hell,” he said.

Kaine acknowledged that Democrats won’t likely have the votes, even in the Senate, to block a reconciliation process that would identify parts of the law that could be repealed with a 51-vote majority.

Kaine’s speech included a lengthy citation of concerns expressed by the American Medical Association over the prospect of an outright repeal of the law.

It also echoed concerns voiced by Virginia hospitals about the details of whatever legal framework would replace it.

“Broadly speaking, it is essential that any action Congress pursues enhances and protects access to health care coverage, ensures more equity within the Medicaid program, adequately reimburses providers, and continues to improve quality and safety,” Sean T. Connaughton, president and CEO of the Virginia Hospital & Healthcare Association, wrote in a letter this week to members of Virginia’s congressional delegation.

The association laid out its parameters for replacing the law, including the restoration of funding cut to hospitals from Medicare and other sources to pay for Medicaid expansion, health insurance exchanges, and other parts of the law designed to reduce the burden of uncompensated health care on providers.

In Virginia, hospitals got the funding cuts, but not relief from serving uninsured people who would have been covered by expanded Medicaid eligibility, and previous attempts at repealing the law through budget reconciliation would not have restored hospital reimbursements.

“Without a mechanism for enhancing coverage, it is simply unfair to maintain hospital-related reimbursement reductions or to rescind them and reinvest the savings elsewhere,” Connaughton said.

The association also voiced concern over proposals to replace current Medicaid funding with a block grant program that, based on past spending, would put Virginia at a steep disadvantage with other states. Instead, Virginia hospitals said they would prefer a per capita allotment without a limit on the number of recipients.

Gov. Terry McAuliffe, a Democrat who still is trying to expand Medicaid in Virginia if the law survives, urged U.S. House Majority Leader Kevin McCarthy, R-Calif., to consider what he termed the law’s benefits to the state’s budget, its hospitals, and working families.

“The Affordable Care Act has had a tremendous positive impact on Virginia, even without the added benefit of Medicaid expansion,” McAuliffe wrote McCarthy on Dec. 30.

In his speech, Kaine shared personal anecdotes from Virginians, including his own family, about what he termed the critical importance of affordable health care coverage.

He recounted a recent conversation with Ashley Hawkins, a Richmond businesswoman and mother, who had been uninsurable before the law’s passage because of a pre-existing medical condition. The law allowed her to purchase health insurance for her family and business that helped cover the hospital costs of one child’s birth, he said.

Having health insurance “’has to do with self-esteem, security and well-being,’” Kaine quoted Hawkins as saying.

He also mentioned a letter from a Williamsburg couple who said they had chosen not to start a family before passage of the Affordable Care Act, because they couldn’t afford health insurance, but began having children after the law’s adoption.

Kaine also talked about the difficulty in getting health insurance for himself and his family after his terms as Virginia governor and full-time chairman of the Democratic National Committee. He said later that his application was rejected because he had used statin medications for about a year to lower his blood cholesterol levels.

“We are a healthy family, and we were turned down twice by insurance companies because of pre-existing conditions,” he said, adding that his wife, Anne Holton, cited protections in the health care law in persuading insurers to change their position.

John Whitbeck, chairman of the Republican Party of Virginia, said in a statement that GOP members of Congress are keeping faith with voters.

“All through the 2017 campaign, Republicans promised to make the repeal and replacement of Obamacare job one if voters trusted us to govern,” he said.

“Now, with a Republican Congress and Republican headed to the White House in just over two weeks, we’re keeping that promise.”